妊高征患者的胎儿血流速度波形改变特点研究

Study on the character of fetal flow velocity waveforms in patients with pregnancyinduced hypertension.

目的：研究妊高征患者的胎儿脐动脉、肾动脉以及大脑中动脉的血流速度波形的变化特点。方法：妊高征患者９６例，正常妊娠１４８例，于产前１周内行彩色多普勒超声检测胎儿脐动脉、肾动脉和大脑中动脉的搏动指数（ＰＩ），产后随访新生儿预后。结果：随着妊高征的加剧，胎儿脐动脉和肾动脉的ＰＩ上升，大脑中动脉的ＰＩ则改变不明显。在围产儿预后良好和不良的两组中，随着妊高征的加重，胎儿脐动脉、肾动脉和大脑中动脉的ＰＩ均有上升的趋势，但预后不良组的改变比对照组明显。按正常妊娠和轻度、中度、重度妊高征分成４组，胎儿窘迫者脐动脉和肾动脉的ＰＩ上升，大脑中动脉的ＰＩ下降。结论：妊高征和胎儿窘迫对胎儿脐动脉和肾动脉的血流波形改变有协同作用。

Objective:To study the character of fetal flow velocity waveforms (FFVWs)of fetal umbilical artery(UA),renal artery(RA) and middle cerebral artery (MCA) in patients with PIH.Methods:96 cases with PIH and 148 normal pregnancies were determined by color Doppler ultrasound for PI of fetal UA, RA and MCA within one week before delivery and the fetal outcomes were evaluated after birth.Results:More serious the PIH was,higher PI of the UA and RA were,but PI of the MCA was not changed significantly.The patients were divided into two groups according to perinatal outcomes:normal and adverse perinatal outcome groups.PI of fetal UA, RA and MCA have trend of increasing from normal pregnancy to serious PIH,but these changes in adverse perinatal outcomes group were significant than those in normal group.In four groups(normal pregnancy,mild,middle and serious PIH),PI of fetal UA and RA were higher and PI of fetal MCA was lower in adverse perinatal outcomes group than that in good perinatal outcomes group.Conclusions:The FFVWs change induced by PIH and fetal distress on fetal UA and RA was synergetic,but on MCA,the action was resistant.